What are antipsychotic medicines?

Antipsychotic medicines (also called 'antipsychotics') are used to treat psychosis. Psychosis is a mental health condition that affects how the brain works. It makes it hard to tell what is real and what isn't.

Psychosis may occur without a clear cause. Psychosis can occur following drug use, including over-the-counter, prescription or recreational drugs. It can also be a symptom of:

• schizophrenia
• bipolar disorder
• severe depression
• brain disorders (such as epilepsy, traumatic brain injury or dementia)

Psychosis can cause significant symptoms, including:

• confused thinking
• delusions — false beliefs that you are certain are true or real
• paranoia — suspicion or mistrust of others without a reason
• hallucinations — seeing, hearing, feeling, smelling or tasting things that are not actually there
• aggression and hostility

Antipsychotic medicines can help reduce or relieve symptoms of psychosis.

They can also calm you down and may help with anxiety and agitation. They can prevent problems with mood, thinking and socialising.

Some antipsychotic medicines work better in combination with psychological therapy, such as cognitive behavioural therapy. This is provided by a psychiatrist or psychologist.

What are the benefits and risks of antipsychotic medicines?

The main benefit of using antipsychotic medicine is relieving symptoms of psychosis.

Psychosis is a serious condition that can affect your health, safety and quality of life. Getting effective treatment for psychosis is important to reduce your risk of harm.

Antipsychotics are an effective way to manage psychosis, but using antipsychotics for more than 2 years may have long-term consequences. Your doctor can help you understand the benefits and risks of long-term antipsychotic use and find a solution that works for you.

How do antipsychotic medicines work?

Many mental illnesses are associated with changes in chemicals in the brain. Everyone has these chemicals, but people with mental illnesses may have too much or too little of some brain chemicals. Antipsychotic medicines are thought to affect the balance of these chemicals, particularly dopamine. The exact way they work is not fully understood and research is ongoing.

What antipsychotic medicines might I be prescribed?

There are different types of antipsychotic medicines. Talk with your doctor or mental health professional about what might work best for you. Each medicine has its own benefits and potential side effects.

Some common antipsychotic medicines include risperidone, olanzapine, aripiprazole and quetiapine.

Different antipsychotics can affect each person in different ways. It's best to talk with your doctor to work out what is right for you. Sometimes a change in dose or the type of medicine you take makes a big difference.

What are the side effects of antipsychotic medicines?

Like all medicines, antipsychotic medicines can cause side effects. Side effects are different for different people. They can also vary depending on the type of medicine and dose.

Common side effects include:

• tiredness or trouble sleeping
• weight gain
• restless movements
• dry mouth
• dizziness
• constipation, nausea or indigestion
• changes in sexual function or desire

Occasionally, antipsychotic medicines can have serious side effects, such as:

• heart problems
• breathing problems
• fever
• confusion
• severe muscle stiffness
• low white blood cell levels

If you are concerned about side effects from your medicine, it's important to talk to your mental health professional. There may be things you can do to reduce side effects, or other medicines you can try instead.

Long-term complications

Some people develop movement problems after taking antipsychotic medicines for years. This may include shaking, stiffness, slow movements or sudden unintended movements.

Because antipsychotics can cause weight gain, over time this can lead to diabetes and other complications of obesity.

Withdrawal effects

If you stop taking your antipsychotic medicine suddenly, without the help of your doctor, you may experience withdrawal effects. These can include 'rebound psychosis', when your psychosis symptoms suddenly come back.

Stopping your antipsychotic suddenly can also cause:

• flu-like symptoms
• nausea and vomiting
• restlessness
• headache
• sweating
• diarrhoea

How do I take antipsychotic medicines?

Most antipsychotic medicines are tablets or other formulations that you need to take every day.

Others are given by injection (called a 'depot' injection). These release medicine into your body slowly over several weeks. Your doctor may recommend a depot injection if you have trouble swallowing tablets or if you find it hard to remember to take your medicine every day. Depot injections also lower the chance of withdrawal symptoms.

Many antipsychotic medicines take several weeks or months to start working. You may need to try a few different ones before you find the type and dose that works well for you.

If you have been prescribed an antipsychotic medicine and it takes a while to work, be patient. It can be dangerous to suddenly stop some antipsychotic medicines. Make sure to speak to your doctor before making any changes.

Some people can lower their dose or stop taking antipsychotics after they have fully recovered from an episode of psychosis. Other people may need to continue to take antipsychotics long term.

When should I see my doctor?

You should see your doctor if you are experiencing severe side effects that affect your quality of life. You should also see your doctor if you are still experiencing symptoms of psychosis even when you take your medicine as prescribed.

Your doctor can discuss things you can do to help manage your symptoms.

Are there any alternatives to this medicine?

Psychological therapies, such as cognitive behavioural therapy (CBT) and family therapy, are often used together with medicine to treat or prevent psychosis.

For some people, psychological therapy without medicine may be enough.

Resources and support

• Visit SANE for information about mental health conditions and medicines used to treat them, as well as for help and support.
• You can read the Mental Health First Aid Australia fact sheet to help people with psychosis.
• For advice and to get connected to local mental health services, call Medicare Mental Health on 1800 595 212.
• Read healthdirect's guide to important questions to ask your pharmacist or doctor before taking a medicine.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

• The Transcultural Mental Health Centre offers consumer medicine brochures in other languages.
• Embrace Multicultural Mental Health offers mental health resources and personal stories translated into more than 30 languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Call 13YARN (13 92 76) for mental health support for Aboriginal and/or Torres Strait Islander peoples.
• Visit Yarn Safe by headspace to find help for people aged 12 to 25 years.